Provider Demographics
NPI:1952563793
Name:THOMAS-TORRES, TIFFANY CAMILLE (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:CAMILLE
Last Name:THOMAS-TORRES
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12188 HESPERIA RD
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5822
Mailing Address - Country:US
Mailing Address - Phone:760-477-2199
Mailing Address - Fax:
Practice Address - Street 1:12188 HESPERIA RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5822
Practice Address - Country:US
Practice Address - Phone:760-477-2199
Practice Address - Fax:760-513-9690
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT78001106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist